BEIRUT: By its very nature, the medical system is focused on curing illness. But this can mean that the concerns of patients with chronic or terminal disease, who often live for relatively long periods in pain, are forgotten or set aside.This is why family physician Hibah Osman founded the Lebanese Center for Palliative Care in 2011. Known as Balsam, the center works to comfort patients with chronic and terminal illnesses, as well as their families.
“When my patients started getting very sick and I didn’t have the resources to support them when they were sick and dying ... the [idea] of palliative care opened up to me,” Osman says.
“We needed to create something so that when patients have serious illnesses, we are able to support them and take care of them because they’re still there, they are still alive and they’re suffering.”
When she initially became interested in the subject, Osman knew little about palliative care. “I didn’t really know what it was about until I was probably 10 years into my practice as a family doctor,” she says, lamenting that this lack of knowledge was common in the Lebanese medical community.
“So I stumbled into it [while] trying to make my patients more comfortable and noticed that there was nothing in palliative care in Lebanon. This is where the idea of Balsam came from.”
Balsam was registered in 2011, but the non-governmental organization’s team has been working together since 2010. Balsam and SANAD, another NGO, are the only two organizations providing palliative care in Lebanon.
Speaking to The Daily Star in Balsam’s Hamra headquarters, Osman details the types of support her organization provides to patients.
“We focus on relieving suffering in the physical sense, in the psychological sense [manifested] by the depression and anxiety associated with serious illness, and in the social and spiritual [senses] as well,” she says.
“Social support includes things like providing equipment, hospital beds, walkers, [and] wheel chairs. If somebody is still undergoing chemotherapy or radiation, [it means] helping them arrange transport to the hospital and from the hospital.”
Balsam provides all its services for free and relies mainly on donations.
“We believe very strongly that death with dignity and relieving suffering is something that everybody should have access to,” Osman says, explaining that Balsam does not charge for its services because it wants them to be accessible to all.
“A big part of what we do is raising awareness, changing legislation, [and] training ... What we hope to do is train health providers to provide this kind of care,” she said.
“Now we are involved in setting medical curricula for medical students and nurses.”
Balsam held a fundraiser at Beirut’s Sky Bar earlier this month, and is asking people to run on its behalf in the November Beirut Marathon.
“We have wonderful supporters, we have a few key anchor donors who have been providing a lot of the support, [but] it is always a struggle,” she says, pointing to rising costs as the staff increases.
Osman says that with a huge demand for the kind of care Balsam offers, the organization is growing quickly.
“It is estimated that about 25,000 people die in Lebanon each year ... of those about 10 percent die suddenly ... the other 90 percent die after chronic illness, whether that is cancer or something else,” says Osman.
“The estimate is that about 60 percent of those people could benefit significantly from receiving palliative care,” she adds.
Balsam has cared for around 50 people since it opened, at first working with one or two patients at once. Now, Osman says the staff – which includes two part-time and one full-time nurse – takes on 10 patients at a time.
Osman notes that Balsam played an active role in pushing for the establishment of the National Committee for Pain and Palliative Care, formed under the Health Ministry in May 2010.
This committee is working to develop a national strategy for palliative care, so that it is both incorporated in the education of doctors and nurses.
Balsam provides constant support for those patients who are relatively close to its Beirut center, Osman said.
“If they are far ... we provide partial support ... We do maybe one visit and help them figure out what their needs are ... and then, for instance, we can provide telephone support.”
Osman says that the reaction of the patients and families who have received palliative care from Balsam has been “extremely positive.”
“Palliative care is not about dying, it is about living life to the fullest despite your illness,” she says. “It’s about saying, ‘I can still participate in life and I can still sit with the family at the dinner table.’”